Are UK cancer cure rates worse than in most other European countries?

Abstract

The review from William Hamilton1 in the current issue of the BJGP is a valuable and careful analysis of where delays might occur in the diagnosis of cancer. The review examines the implications for appropriate management when patients first present with symptoms that could be due to many causes, including cancer. Early diagnosis of cancer is essential and delay may reduce the chance of cure. Delay in diagnosis is not a feature exclusive to the UK healthcare system. It is often very difficult to determine when the first symptoms of a cancer occur, so that comparing treatment delays between one UK practice and another, let alone between countries, is a difficult thing to do. There is no reason to suppose that UK doctors are worse trained or more careless than those in other countries. Of course, if there are identified, verifiable, institutional delays, these must be rectified and it is encouraging to see the steps that are now being taken to do this.2 To illustrate the importance of timely diagnosis, Hamilton refers to studies that state that UK cure rates are below those in many European countries. This widely quoted assertion comes from the findings in the EUROCARE studies.3,4 However the EUROCARE data are susceptible to several potential biases that mean that we must interpret the studies with caution. The need for rapid diagnosis of cancer stands on its own and does not rest on the basis of the EUROCARE data. The EUROCARE-4 data are the latest in a programme of studies based on data collected from participating European cancer registries. The aims are to determine whether there are differences in cure rates for cancers in European countries, whether any such differences and cure rates are changing with time, and to relate any observed differences …